Legal Medicine - Articles in Press

Morphological analysis of astrocytes in the hippocampus in mechanical asphyxiation - Corrected Proof

2010-02-08

Abstract: The present study investigated the morphology of astrocytes in the hippocampus and serum S100B levels in cases of mechanical asphyxia due to neck compression (n=23: atypical hanging, n=7; ligature/manual strangulation, n=16) with regard to the classical autopsy findings, compared with those of other types of asphyxiation (n=9) and acute myocardial infarction/ischemia (AMI, n=20). The decrease in intact astrocyte number, as shown by S100 and GFAP-immunostaining, was larger for asphyxiation due to neck compression compared with that for other asphyxiation and AMI, showing a correlation with the increase in the serum S100B levels. The decrease in intact astrocyte number and increase in serum S100B were closely related to the severity of conjunctival petechial hemorrhage and fracture(s) of the hyoid bone and/or thyroid cartilage in asphyxia due to neck compression. These findings suggest that hippocampal astrocyte injury is caused by cerebral hypoxia accompanied by congestion, especially in mechanical asphyxia due to neck compression.

Relationships between suicide and three economic factors in South Korea - Corrected Proof

2010-02-01

Abstract: The number of suicides in South Korea totaled 4840 in 1995 and 8569 in 1998; in Japan, suicides totaled 21,420 in 1995 and 31,755 in 1998. Suicide prevention is an important issue for both South Korea and Japan. In South Korea, factors related to the increase in suicides must be clarified, and specific suicide prevention measures must be promptly discussed in order to decrease the number of suicides. Therefore, this report examined suicide and unemployment rates and increased rates of mining and industrial production and of money supply in South Korea from 1990 to 2002. This report also discusses the relationships between suicide and unemployment rates and increased rates of mining and industrial production and increased rates of money supply during the same period.During the period studied, annual suicide rates ranged from 7.1 to 18.3 per 100,000 populations. Multiple regression analysis indicated that the suicide rate was clearly related to the unemployment rate, but the suicide rate was not related to increased rates of mining and industrial production and increased rates of money supply. Thus, when unemployment rates increase, relevant organizations and the community should pay close attention to the increase in suicide rates.

Cerebellar contusions as a possible cause of traumatic basal subarachnoid hemorrhage: A case report - Corrected Proof

Jian-Hua Chen, Takaki Ishikawa, Tomomi Michiue, Hitoshi Maeda — 2010-02-01

Abstract: Traumatic basal subarachnoid hemorrhage (TBSAH) is infrequent but of forensic neuropathological importance because of its high mortality and complex causal mechanisms. The source of the hemorrhage is most frequently identified in the vertebro-basilar arteries but often cannot be identified in these arteries. We present a case of TBSAH possibly originating from hemorrhagic cerebellar contusions due to fist blows to the neck. A 35-year-old woman, who was punched on the right side of the neck, became unconscious about 20min later and died. Autopsy demonstrated a massive subarachnoid hemorrhage at the base of the brain, with blood clots attached to the right lower surface of the cerebellum. No tear was detected in the vertebro-basilar vessels, but there were hemorrhagic cerebellar contusions beneath the blood clots as a possible source of TBSAH. The site of impact to the neck suggested the cerebellar contusions to be a coup injury due to hard blows.

Genetic analysis of 17 Y-chromosomal STRs haplotypes of Chinese Tibetan ethnic minority group - Corrected Proof

Zhou Yi, Wang Jun, Song XingBo, Lu XiaoJun, Ding Liu, Ying BinWu — 2010-01-29

Abstract: We have co-amplified and analyzed 17 Y-chromosomal STRs loci (DYS19, DYS389I/II, DYS390, DYS391, DYS392, DYS393, DYS438, DYS439, DYS437, DYS448, DYS456, DYS458, DYS635, YGATA-H4 and DYS385a/b) in 132 healthy unrelated autochthonous male individuals of Chinese Tibetan ethnic group residing in Lassa area of China. The gene diversity values for the Y-STRs loci ranged from a minimum 0.206 for DYS391 locus to a maximum of 0.912 for DYS385a/b locus in the populations. A total of 123 haplotypes were identified, among which 115 were unique and 8 occurred more than once. The overall haplotype diversity for 17 Y-STRs loci was 0.998. Research results will be valuable for forensic use in the regions and for Chinese population genetic study.

Cardiothoracic ratio in postmortem chest radiography with regard to the cause of death - Corrected Proof

2010-01-29

Abstract: It is difficult to examine the intact in situ status of thoracic organs, including the heart and lungs, after opening the chest at autopsy. The present study investigated the pathological diagnostic significance of the cardiothoracic ratio (CTR) with regard to heart and lung weight in postmortem plain chest radiography. The pathological diagnostic significance of the CTR in postmortem plain chest radiography using serial forensic autopsy cases of adults (>19years of age, n=367, within 72h postmortem) was retrospectively investigated. In natural deaths, CTR was larger for heart diseases, and was smaller for pulmonary infection and gastrointestinal bleeding, showing correlations to the heart weight except in cases of hemopericardium. In traumatic deaths, CTR was larger in cases of fire fatality and acute methamphetamine intoxication, and varied in cases of blunt injury, showing correlations to the heart weight. However, CTR was smaller for sharp instrument injury and drowning, independently of the heart weight. These findings suggest that postmortem CTR (median, 55.6%, measured using a mobile X-ray apparatus) primarily depends on the heart weight, but is substantially modified during the process of death: the CTR may be enlarged by cardiac dilatation due to terminal congestive heart failure, but may be reduced by inflated lungs in drowning or hypovolemia due to fatal hemorrhage. CTR showed a mild correlation to the right diaphragm level, which was also related to the cause of death, but was independent of the left diaphragm level. Plain chest radiographic findings may also be helpful in investigating the pathophysiology of death, and are to some extent comparable with clinical findings. This also suggests the potential usefulness of postmortem CT and MRI for analysis of terminal cardiac function.

Is “Toxopsy” the next step after virtopsy? - Corrected Proof

Fabio De-Giorgio, Simona Martello, Marcello Chiarotti, Giuseppe Vetrugno — 2010-01-29

We read with great interest the original article by Maeda et al. in the April 2009 special issue of the Journal. According to literature previously published, the authors believe that laboratory tests are an almost indispensable tool for medico-legal examinations of corpses.

Microglial and astrocytic changes in the striatum of methamphetamine abusers - Corrected Proof

2010-01-28

Abstract: Little is known about the role of glial cells in the striatum of chronic methamphetamine (METH) users. In this study, we immunohistochemically examined glial reactions in the striatum of chronic METH users who did not abstain from METH use and died of drug intoxication. Human glucose transporter 5 (hGLUT), a useful marker of microglia, and CR3.43, a major histocompatibility complex class II antigen specific for reactive microglia, were immunostained. Glial fibrillary acidic protein (GFAP) and S100Β were used for astrocyte immunohistochemistry. We analyzed 12 chronic METH users and 13 control subjects, and detected a 200–240% increase in the number of hGLUT5-positive cells in chronic METH users (p<0.01). However, we did not detect any proliferation of CR3.43-positive cells. The number of GFAP-positive astrocytes increased, but this increase was not significant (p>0.05). Moreover, S100B-positive cell density between the two groups was not significant (p>0.05). This study demonstrates the absence of reactive gliosis in the striatum of chronic METH users who did not abstain for prolonged periods from METH use. The results suggest that chronic METH use by itself did not activate glial cells in humans and reactive gliosis may not be involved in the mechanism underlying the loss of control in drug intake, which is a characteristic feature of drug addiction.

Sudden death due to a hypopharyngeal mass during sleep: A case report - Corrected Proof

Silvia Perotti, Marzia Vassalini — 2010-01-28

Abstract: It is not frequent to find during the autopsy a lymphoid hyperplasia located in the hypopharynx. The literature reports numerous cases characterized by the presence of a mass, non-malignant too, in this particular anatomical district; in these cases the neoformation plays an important role in explaining the cause of death through different asphyxial mechanisms.We present a case of a 44-year-old man, in apparent good health, who suddenly died during sleep. The autopsy revealed an hypopharyngeal lymphoid hyperplasia that can provide the asphyxial mechanisms as cause of death.Furthermore, the anatomical finding could be integrated by a circumstantial piece of evidence: the death occurring during sleep. Some studies, in fact, have highlighted the physio-pathological mechanisms to explain sleep-disordered breathing, particularly the muscular and neural changes involving the pharynx.The asphyxial mechanism was also studied by an immunoistochemical analysis with the anti-Human Surfactant Apoprotein-A (SP-A) antibody.

Application of the drowning index to actual drowning cases - Corrected Proof

2010-01-28

Abstract: The drowning index (DI) was devised to diagnose drowning deaths, and is the weight ratio of the lungs and pleural effusion to the spleen. Among drowning (94 cases), mechanical asphyxia (47 cases), and acute cardiac (42 cases) deaths, within 2weeks postmortem we compared six markers, the weight of each lung, pleural effusion weight, total weight of the lungs and pleural effusion, spleen weight, heart weight, and the DI. Statistical analysis revealed that the total weight was heavier, while spleen weight was lighter, and the DI was significantly larger in the drowning group (p<0.05). We examined the relation between the postmortem time and these markers. We divided 94 drowning cases into three groups according to the postmortem duration, group A (0–3days; 43 cases), group B (3–7; 29 cases), and group C (7–14; 22 cases). The cut-off point of the DI was analyzed using the receiver operating characteristic (ROC) curve. As a result, the DI cut-off point was 14.1 in cases within two postmortem weeks. Drowning is still a difficult autopsy diagnosis, but in our experience, DI is a valuable indicator.

A silent allele in the locus D19S433 contained within the AmpFℓSTR® Identifiler™ PCR Amplification Kit - Corrected Proof

2010-01-28

Abstract: We present two cases where a single locus mismatch was found in the locus D19S433 using the AmpFℓSTR® Identifiler™ PCR Amplification Kit (Applied Biosystems) (Identifiler Kit) during paternity and maternity tests. This mismatch differed from the mismatch pattern where there is usually a one repeat difference. We designed forward and reverse primers so that they were positioned further away from the primer set contained in the Identifiler Kit. The results showed the existence of a silent allele 13 in both families, due to a point mutation that changed guanine to adenine at 32 nucleotides downstream from the 3′ end of the AAGG repeat sequences in all four members. A single locus mismatch due to a silent allele may occur in any locus using any kit. Accordingly, we should pay attention to this silent allele when carrying out human identification and parentage analysis.

Detection of metallic elements from paraffin-embedded tissue blocks by energy dispersive X-ray fluorescence spectrometry - Corrected Proof

Motonori Takahashi, Hiroshi Kinoshita, Minori Nishiguchi, Hajime Nishio — 2010-01-28

Abstract: Energy dispersive X-ray fluorescence spectrometry (EDX) enables rapid, non-destructive, multi-elemental analysis. Using EDX, lead and some other metallic elements were detected in paraffin-blocks in which skin samples from a gunshot wound were embedded. Lead was not identified in control samples from non-injured cases. These findings indicate that EDX is a useful method for rapid non-destructive analysis of paraffin-embedded blocks. This technique can provide scientific evidence for identification of a firearm even after storing the sample for a long time.

Evaluation of a new experimental kit for the extraction of DNA from bones and teeth using a non-powder method - Corrected Proof

2010-01-28

Abstract: An experimental DNA extraction kit (new kit) was recently developed to extract DNA from degraded skeletal remains without the need for powdering the samples. We compared the utility of the new kit with the conventional phenol/chloroform method using real-time quantitative PCR and multiplex STR analysis. The new kit yielded large amounts of DNA from a compact bone fragment compared with the conventional phenol/chloroform method. We were able to extract sufficient DNA for STR analysis from 75% (3 of 4) and 60% (3 of 5) of the un-powdered tooth and bone samples, respectively, using the new kit. We were able to perform mini-STR analysis of the remaining samples using DNA extracted with the new kit. Furthermore, we successfully performed mitochondrial DNA sequencing of every sample. The new kit simplifies the DNA extraction procedure as it does not require powdering samples. Decreasing the number of procedural steps in DNA extraction will be beneficial in controlling DNA contamination in laboratories. Our results suggest that the new kit may be used for the simple, simultaneous extraction of DNA from multiple samples.

Autopsy case of a patient with 13q− syndrome - Corrected Proof

2010-01-28

Abstract: Partial deletion of the long arm of chromosome 13 results in 13q− syndrome, and phenotypes of affected patients vary widely. We describe an autopsy case of the sudden, unexpected death of a 17-year-old boy with 13q− syndrome. He had severe psychomotor retardation and had been receiving follow-up care. One day he was found dead in his house and autopsy was performed to elucidate the cause of death. Autopsy findings revealed lobulation anomalies of the lungs, hypoplasia of the adrenal and thyroid glands, and apituitarism due to hyperplasia of bone in the hypophyseal fossa. No other pathological lesions were observed. Chromosomal analysis confirmed interstitial deletion from the long arm of chromosome 13. Karyotype was 46,XY, del(13)(q14.3q32). We concluded that the patient died of multi-organ dysfunction due to apituitarism. Autopsy cases of 13q− syndrome are rare. Furthermore, lobulation anomalies and apituitarism associated with 13q− syndrome have not previously been described. This case report offers novel clues to elucidating critical regions of chromosome 13 associated with malformations of the lungs and pituitary gland.

Sequence polymorphism of the mitochondrial DNA control region in the population of Vojvodina Province, Serbia - Corrected Proof

2009-12-07

Abstract: In order to generate and establish the database for forensic identification purposes in Vojvodina Province (Serbia), the sequence of the hypervariable regions 1 (HV1) and 2 (HV2) of the mtDNA control region were determined in a population of 104 unrelated individuals from Vojvodina Province, using a fluorescent-based capillary electrophoresis sequencing method. A total of 93 different haplotypes were found, of these 83 mtDNA types were unique, nine haplotypes were shared by two individuals and one haplotype by three individuals. The variation of mtDNA HV1 and HV2 regions was confined to 116 nucleotide positions, of which 72 were observed in the HV1 and 44 in the HV2. A statistical estimate of the results for this population showed the genetic diversity of 0.9977 and the random match probability of 1.18%. Haplogroup H was the most common haplogroup (43.3%). Haplogroups observed at intermediate levels included clusters U (13.5%), T (10.6%), J (8.6%) and W (5.8%).